Conclusion
Molecular screening plays an important role in diagnosing LTBI and
reactivation TB. However, careful understanding of the mechanism behind
these molecular tests, as well as thorough interview/chart review is
important to effectively diagnose and treat TB in immunocompromised
patients. Detection protocols should use TST, IGRA and chest imaging to
increase sensitivity, as well as MCT-PCR to rule out active disease in
patients with high clinical suspicion. Furthermore, TB protocols in
immunocompromised patients with high clinical suspicion should include
airborne isolation and prophylaxis at presentation, even with negative
IGRA.